MEDICAL MEMORANDA MBDICALJOURNAL Large haematomas are, of course, frequent after blunt trauma, and it is surprising that more arteriovenous fistulae do not develop.As stated above, a special anatomical situation must necessarily exist in which vessels rupture into a confined space.The open venous channel affords the line of least resistance for the blood under arterial pressure, rather than diffusion of the blood inta the tissues such as normally occurs.If the vascular shunt is maintained the channel will gradually become organized and lined with endothelium, and an arteriovenous fistula will have been established.
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Horne et al. (1958) studied this question.